The Status Analysis Of Network Reporting System For Infectious Diseases In Tai’an And Its Influencing Factors

[Background]In 2003,the outbreak and spread of SARS revealed the problems and shortcomings in chinese monitoring system for infectious disease.In recent years,the new breakout of infectious diseases and its control provides the dual challenges of existing and new infectious diseases.Reliable source of epidermic information ensures to grasp the epidemic dynamics accurately and timely.Therefore,it becomes the primary task and important responsibilities for the public health department to establish a solid,long-term and sensitive reaction of information monitoring system for the infectious disease.[Objective]This studay aims to:1.Understand the current situation of the management and reporting quality of infectious diseases in Tai’an,and to find out the problems in the network reporting of infectious diseases and the influencing factors.2.Get a knowledge of Tai’an City infectious disease automatic warning and emergency public health events and related information occurrence,thus to provide the basis and related information for early detection,early control of public health emergencies,as well as the epidemic spread.3.Explore the need to improve the management of epidemic reporting in Tai’an,and to develop appropriate solutions to make it more scientific and standardized management.[Methods]1.Data was obtained from the infectious disease information reporting management system in Tai’an city from 2004 to 2016,which includes the reported infectious disease card,infectious disease network reporting system,and personnel status questionnaire.2.The information system for Chinese center for disease control(CDC)was used to collect the cases of the public health emergencies from 04/21/2008 to 9/30/2016.And the related information was analyzed which includes the warning information,the handling of public health emergencies.[Results]1.The coverage rate of network equipment for 157medical institutions and personnel in Tai’an City is 100%,and the smooth operation rate for these is 100%.Totally 175 people work for the epidemic report management system.Among them,more than 40 years accounted for 58.86%(103/175),40 years of age accounted for 41.14%(72/175);primary and below the title of the majority,52%(91/175),intermediate and senior professional titles accounted for 48%(84/175);college degree accounted for 33.71%(59/175),bachelor degree or above accounted for 30.29%(53/175);24.57%(43/175)work for full-time,and 75.43%(132/175)work for part-time.Engaged in the work of the epidemic of more than 2 years of age accounted for(158/175),accounting for less than 2 years(17/175).The network of direct reporting staff for the nursing profession,accounting for 42.28%(74/175),public health professionals accounted for 26.29%(46/175).CDC at all levels are equipped with special computer and special computer,medical institutions,the prevalence rate of the special computer is 73.88%(116/157).2.Reporting status of legal infectious diseases.The network reporting of infectious diseases started on January 1,2004 in Tai’an.The highest incidence of infectious diseases is 438.79/100,000 in 2014;the minimum incidence was 144.54/100,000 in 2007.The highest mortality rate of infectious diseases is 0.42/100,000 which was in 2011;the lowest mortality is 0.036/100,000 of 2004.During the whole period(2004-2016),starting from 2008,incidence of infectious disease Tai’an city began to rise,and reached peak in 2010,2012,2014.A report of non-infectious diseases,B infectious diseases reported diseases were higher than those of C class.The incidence of respiratory infectious disease was higher than those of other transmission routes.The reporting cards of infectious diseases were mainly from general hospitals,accounting for 67.83%of the total report.This was followed by community hospitals,which accounting for 11.79%.the cases which were not reported timely or audited timely decreased from 2004 to 2016.Totally 91 duplicate reports were identified during the period from 2004 to 2006,while no duplicate reports were found after 2006.All counties reported cases during the whole time.3.From April 21,2008 to September 30,2016 in Tai’an city received a total of 8815 early warning signals,which covered 32 diseases.And the signal response rate in 2 hours was 76.98%(6786/8815),signal response rate in 24h was 95.98%(8461/8815).The median duration of response was 0.59h.Among all the reports,19 of them were confirmed to be outbreaks/epidemic events after the field investigation,and the positive rate of early warning signal is 0.22%.in Tai’an city,there were 134 reports of public health emergencies and related incidents,16 of them have a warning signal,which all are infectious diseases.Fifteen cases includes schools and kindergartens;including 8 hand-foot-and-mouth disease(HFMD)cases,5 mumps,2 varicella.4.Influencing factors of the network reporting system of infectious disease:The concept of reporting time limits for infectious diseases is vague.The diagnosis of infectious diseases is not accurate,and clinicians are not aware of or indifference to the epidemic.Epidemic management personnel were replaced frequently,which made the personnels were not familiar with the procedures,and can not conduct effective supervision and management of the epidemic reporting,and are insensitive to the infectious disease,which complicates the early detection of infectious disease in the hospital.[Conclusion]1.Tai’an infectious diseases network reporting system has achieved full coverage,which provides an effective channel and reliable basis for the early detection and control of the spread of infectious diseases.2.Infectious disease report cards,the rate of timely report and audit were increased year by year,but there are the following issues:incomplete information for the report,the inconsistence between report cards and electronic card information network reported,missing report,missing ID number on the card and other issues.To some extent,all of these issues influenced the quality of infectious disease information report in Tai’an,which not only hidden the potential outbreak of infectious disease,but also get the pseudo-low incidence of infectious diseases.All of these might affect the health decision-making.3.The main existing problems are:the personnel changes frequently,the lack of full-time staff,the mismatch of professional counterparts,age issues.And the open of two-child policy in recent years also worsen the situation.4.The automatic warning system of infectious disease played an important role in the early detection and control of the epidermic outbreak,but the positive rate of early warning is low.so it is still the focus and difficulty to strengthen the early warning and monitoring work.